In performing various surgical procedures on the head, it is often necessary for the surgeon to make lengthy incisions in the patient's scalp so as to expose the underlying anatomical structure. The free ends of the scalp tissue are generally clamped off during the surgery to minimize blood loss, and then the incisions are closed back up at the conclusion of the surgical procedure. Hemostatic clips for clamping off the tissue, and applicators for applying those clips to the scalp, are well known in the art.
For example, U.S. Pat. No. 3,604,425, issued to LeRoy, teaches a hemostatic clip in the form of a tubular body member having a longitudinal slit extending completely across the body. The slit is adapted to receive a wound flap when the tubular body is distended from its original shape. A pair of projections project outwardly from the body member along a longitudinal line disposed about 90.degree. from the slit. These projections act as a convenient means for distending the body from its original shape when an external force is applied to the two projections. A pliers-type applicator is also taught in the patent to LeRoy. LeRoy, however, does not disclose any means for maintaining a plurality of his clips in position for ready application to an incision site.
U.S. Pat. Nos. 4,612,932 and 4,637,395, both issued to Casper et al., teach a scalp clip applicator and magazine system. The applicator is adapted to apply C-shaped scalp clips one after another to the skin flaps of an incision. The clip applicator and magazine system of Casper et al. alleviates the need to insert an individual scalp clip into the applicator after each preceding clip has been applied to the skin flaps. To this end, Casper et al. teach a magazine for holding a plurality of scalp clips one behind the other. The magazine arranges the free end of each scalp clip so that it rests against the bridge of its preceding scalp clip. In this way, the scalp clips are properly oriented within the magazine. The magazine guides the scalp clips as they are displaced toward an open end of the magazine by spring means. A stationary jaw is disposed at the open end of the magazine to help maintain the scalp clips within the magazine prior to their application to the incision site. When the magazine is assembled to the applicator, this stationary jaw is positioned in opposing relation to a movable jaw which is disposed on the applicator.
With the device of Casper et al., the magazine's stationary jaw and the applicator's movable jaw are initially arranged in a first position in which they are remote from one another. In this first position, the magazine's stationary jaw projects downwardly, and the applicator's movable jaw projects upwardly, with respect to the feed path of the scalp clips. In this way, as a leading portion of a scalp clip moves past the magazine's stationary jaw and the applicator's movable jaw, a trailing portion of the scalp clip engages both the magazine's stationary jaw and the applicator's movable jaw so as to halt forward movement of the scalp clip relative to the magazine. When the scalp clip is to be deployed, the applicator's movable jaw is brought closer to the magazine's stationary jaw so as to deform the trailing portion of the scalp clip. This in turn causes the leading portion of the scalp clip to expand so that the scalp clip may be applied to the incision site.
Unfortunately, the device disclosed in the Casper et al. patents can sometimes "spit" clips. In addition, the device disclosed in the Casper et al. patents cannot be used to remove deployed scalp clips at the conclusion of the surgical procedure.
U.S. Pat. No. 4,854,317, issued to Braun, teaches an applicator for C-shaped scalp clips, wherein the applicator comprises a stationary edge, a movable edge, and a scalp clip retaining element. The movable edge of the applicator can be brought toward the stationary edge while the retaining element is fixed in its open position so as to apply a scalp clip to an incision site. When the direction of motion of the movable edge is reversed, the movable edge immediately causes the retaining element to assume its locked position.
Unfortunately, while the device disclosed in the Braun patent tends to prevent clip spitting, it is also relatively complex in construction. Furthermore, the device disclosed in the Braun patent cannot be used to remove a scalp clip at the conclusion of the surgical procedure.